Nurse-led implementation of a safe and effective intravenous insulin protocol in a medical intensive care unit

Critical Care Nurse

Volumn 31, Issue 6, 2011, Pages 27-35

  Khalaila, Rabia ^a   Libersky, Eugene ^a   Catz, Dina ^a   Pomerantsev, Elina ^a   Bayya, Abed ^a   Linton, David M ^a   Sviri, Sigal ^a  

^a HADASSAH HEBREW UNIVERSITY MEDICAL CENTER   (Israel)

Author keywords

[No Author keywords available]

Indexed keywords

ANTIDIABETIC AGENT; INSULIN;

AGED; ARTICLE; CASE CONTROL STUDY; CLINICAL PROTOCOL; FEMALE; FOLLOW UP; GLUCOSE BLOOD LEVEL; HUMAN; INTENSIVE CARE; INTENSIVE CARE UNIT; INTRAVENOUS DRUG ADMINISTRATION; MALE; METHODOLOGY; MIDDLE AGED; NURSING; NURSING EVALUATION RESEARCH; NURSING METHODOLOGY RESEARCH; NURSING PRACTICE; ORGANIZATION AND MANAGEMENT; PROSPECTIVE STUDY; RETROSPECTIVE STUDY; TREATMENT OUTCOME;

AGED; AGED, 80 AND OVER; BLOOD GLUCOSE; CASE-CONTROL STUDIES; CLINICAL PROTOCOLS; CRITICAL CARE; FEMALE; FOLLOW-UP STUDIES; HUMANS; HYPOGLYCEMIC AGENTS; INFUSIONS, INTRAVENOUS; INSULIN; INTENSIVE CARE UNITS; MALE; MIDDLE AGED; NURSE'S PRACTICE PATTERNS; NURSING EVALUATION RESEARCH; NURSING METHODOLOGY RESEARCH; PROSPECTIVE STUDIES; RETROSPECTIVE STUDIES; TREATMENT OUTCOME;

EID: 84857649760     PISSN: 02795442     EISSN: None     Source Type: Journal    
DOI: 10.4037/ccn2011934     Document Type: Article

References (33)

1. Byrum D. Why is it so important to treat hyperglycemia in critically ill patients? Crit Care Nurse. 2004;24(2):86-90.
2. Van den Berghe G, Wouters PJ, Bouillon R, et al. Outcome benefit of intensive insulin therapy in the critically ill: insulin dose versus glycemic control. Crit Care Med. 2003;31(2):359-366.
3. McCowen KC, Malhotra A, Bistrian BR. Stress-induced hyperglycemia. Crit Care Clin. 2001;17(1):107-124.
4. Van den Berghe G. Tight blood glucose control with insulin in " real-life" intensive care. Mayo Clin Proc. 2004;79(8):977-978.
5. Lewis KS, Kane-Gill SL, Bobek MB, Dasta JF. Intensive insulin therapy for critically ill patients. Ann Pharmacother. 2004;38(7-8):1243-1251.
6. Bradley C. Intensive insulin therapy in critically ill patients. Intensive Crit Care Nurs. 2002;18(2):128-129.
7. Krinsley JS. Effect of an intensive glucose management protocol on the mortality of critically ill adult patients. Mayo Clin Proc. 2004;79(8):992-1000.
8. Umpierrez GE, Isaacs SD, Bazargan N, You X, Thaler LM, Kitabchi AE. Hyperglycemia: an independent marker of in-hospital mortality in patients with undiagnosed diabetes. J Clin Endocrinol Metab. 2002;87(3):978-982.
9. Trence DL, Kelly JL, Hirsch IB. The rationale and management of hyperglycemia for in-patients with cardiovascular disease: time for change. J Clin Endocrinol Metab. 2003;88(6):2430-2437.
10. Krinsley JS. Association between hyperglycemia and increased hospital mortality in a heterogeneous population of critically ill patients. Mayo Clin Proc. 2003;78(12):1471-1478.
11. van den Berghe G, Wouters P, Weekers F, et al. Intensive insulin therapy in the critically ill patients. N Engl J Med. 2001;345(19):1359-1367.
12. Kanji S, Singh A, Tierney M, Meggison H, McIntyre L, Hebert PC. Standardization of intravenous insulin therapy improves the efficiency and safety of blood glucose control in critically ill adults. Intensive Care Med. 2004;30(5):804-810.
13. Laver S, Preston S, Turner D, McKinstry C, Padkin A. Implementing intensive insulin therapy: development and audit of the Bath insulin protocol. Anaesth Intensive Care. 2004;32(3):311-316.
14. Solano T, Totaro R. Insulin therapy in critically ill patients. Curr Opin Clin Nutr Metab Care. 2004;7(2):199-205.
15. Whitehorn LJ. A review of the use of insulin protocols to maintain normoglycaemia in high dependency patients. J Clin Nurs. 2007;16(1):16-27.
16. Zimmerman CR, Mlynarek ME, Jordan JA, Rajda CA, Horst HM. An insulin infusion protocol in critically ill cardiothoracic surgery patients. Ann Pharmacother. 2004;38(7-8):1123-1129.
17. Braithwaite SS, Edkins R, Macgregor KL, et al. Performance of a dosedefining insulin infusion protocol among trauma service intensive care unit admissions. Diabetes Technol Ther. 2006;8(4):476-488.
18. Markovitz LJ, Wiechmann RJ, Harris N, et al. Description and evaluation of a glycemic management protocol for patients with diabetes undergoing heart surgery. Endocr Pract. 2002;8(1):10-18.
19. Goldberg PA, Siegel MD, Sherwin RS, et al. Implementation of a safe and effective insulin infusion protocol in a medical intensive care unit. Diabetes Care. 2004;27(2):461-467.
20. Van den Berghe G, Wilmer A, Hermans G, et al. Intensive insulin therapy in the medical ICU. N Engl J Med. 2006;354(5):449-461.
21. Alm-Kruse K, Bull EM, Laake JH. Nurse-led implementation of an insulininfusion protocol in a general intensive care unit: improved glycaemic control with increased costs and risk of hypoglycaemia signals need for algorithm revision. BMC Nurs. 2008;7:1.
22. Oeyen SG, Hoste EA, Roosens CD, Decruyenaere JM, Blot SI. Adherence to and efficacy and safety of an insulin protocol in the critically ill: a prospective observational study. Am J Crit Care. 2007;16(6):599-608.
23. Finfer S, Chittock DR, Su SY, et al. Intensive versus conventional glucose control in critically ill patients. N Engl J Med. 2009;360(13):1283-1297.
24. Reed CC, Stewart RM, Sherman M, et al. Intensive insulin protocol improves glucose control and is associated with a reduction in intensive care unit mortality. J Am Coll Surg. 2007;204(5):1048-1055.
25. Wiener RS, Wiener DC, Larson RJ. Benefits and risks of tight glucose control in critically ill adults: a meta-analysis. JAMA. 2008;300(8):933-944.
26. Meijering S, Corstjens AM, Tulleken JE, Meertens JH, Zijlstra JG, Ligtenberg JJ. Towards a feasible algorithm for tight glycaemic control in critically ill patients: a systematic review of the literature. Crit Care.2006;10(1):R19.
27. Chant C, Wilson G, Friedrich JO. Validation of an insulin infusion nomogram for intensive glucose control in critically ill patients. Pharmacotherapy. 2005;25(3):352-359.
28. Ku SY, Sayre CA, Hirsch IB, Kelly JL. New insulin infusion protocol improves blood glucose control in hospitalized patients without increasing hypoglycemia. Jt Comm J Qual Patient Saf. 2005;31(3):141-147.
29. Bode BW, Braithwaite SS, Steed RD, Davidson PC. Intravenous insulin infusion therapy: indications, methods, and transition to subcutaneous insulin therapy. Endocr Pract. 2004;10(suppl 2):71-80.
30. Stegenga ME, Vincent JL, Vail GM, et al. Diabetes does not alter mortality or hemostatic and inflammatory responses in patients with severe sepsis. Crit Care Med. 2010;38(2):539-545.
31. Osburne RC, Cook CB, Stockton L, et al. Improving hyperglycemia management in the intensive care unit: preliminary report of a nursedriven quality improvement project using a redesigned insulin infusion algorithm. Diabetes Educ. 2006;32(3):394-403.
32. Davidson PC, Steed RD, Bode BW. Glucommander: a computerdirected intravenous insulin system shown to be safe, simple, and effective in 120,618 h of operation. Diabetes Care. 2005;28(10):2418-2423.
33. Juneja R, Roudebush CP, Nasraway SA, et al. Computerized intensive insulin dosing can mitigate hypoglycemia and achieve tight glycemic control when glucose measurement is performed frequently and on time. Crit Care. 2009;13(5):R163.